| NPI | 1225168412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 2241) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 498) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-09 |